Senate okays Medicaid watchdog overhaul

The Senate passed a bill Tuesday that seeks to revamp the state agency that investigates fraud, waste and abuse in Medicaid and other state health services. The Office of Inspector General at the Health and Human Services Commission is supposed to act as a watchdog over state healthcare services, but Senator Juan “Chuy” Hinojosa of McAllen said the agency was rife with problems. During its very first Sunset review, he said, the Commission found the OIG had no set procedures for investigating allegations of fraud and abuse and was often slow and ineffective. “The OIG’s investigative process lacks structure, guidelines and performance measures to ensure consistent and fair results,” said Hinojosa. Investigations that should have taken months stretched into years in spite of a budget increase of 30 percent since 2011. This means that payments meant to go to providers could remain in limbo, in some cases up to 10 years, while the OIG investigates.